Category: Human Rights

THE Citizens-Police Liaison Committee, or CPLC, recently released data on crime in Karachi in 2017. It confirms that we live under the shadow of death in this city that was once predicted to become the queen of the East. In 11 months until end November 2017, 54,473 crimes including killings, robberies, kidnappings and extortions were registered. Many were not even reported as the victims did not deem them serious enough to get involved with the police.

Criminologists and anthropologists would enumerate many factors and conditions that account for the rising crime graph in Karachi in the span of a few decades. Continue reading “Say no to guns”

In 2013, my friend, Perveen Rehman, a popular, soft-spoken development worker, was gunned down in Pakistan’s southern port city of Karachi. She was shot in the neck three times as she returned home from work. The same year, according to media reports, approximately 2,789 people were also killed in the city. Although it’s difficult to obtain accurate figures on the cause of these deaths, it appears that many were the result of gun violence.

In addition to Perveen, two other people I knew were killed that year. Two years later, we lost Sabeen Mahmud, a social activist. She fell victim to armed extremists who wanted to silence her outspokenness.

The high rate of fatalities due to the widespread prevalence of guns has earned Karachi the notorious reputation of being one of the “least safe” cities in the world. Mercifully, the number of killings has declined in the past few years due to a crackdown by law enforcement agencies. However, the gun culture in Pakistan continues to thrive, a result, in part, of its foolish decision in 1979 to play the American proxy in Afghanistan. That opened the floodgates to heroin and Kalashnikovs, which quickly led to the gun violence we contend with today.

Before Pakistan’s involvement in the Soviet-Afghan war, Karachi was a peaceful city. So how did citizens react to this about-face regarding the security situation? Most turned despondent and grew fearful. Given the government’s failure to provide protection, citizens adjusted their lifestyles to ensure maximum protection for themselves and their families by purchasing guns. But a few brave souls chose not to take the situation lying down. One of them is Naeem Sadiq, an industrial engineer who is also engaged in research and activism to promote social causes. About 15 years ago, he started looking into what he calls “the disease of uncontrolled burgeoning weapons that were being used in crime and militancy.”

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Sadiq concedes that every society has its share of conflicts and differences. What worries him is the fact that “the ready availability of weapons shrinks the space for dialogue and people tend to pull out a gun to seek a quick solution.”

He is right. Lives have been lost due to petty street crimes. But what should prompt one to ponder the gravity of the situation is that weapons have become tools for people to give vent to anger and frustration. Incidents have been reported, for instance, of a driver pulling out a gun and shooting another driver who dared to overtake the vehicle of the first. Similarly, jilted suitors have been known to use guns to teach their beloveds a lesson for turning down marriage proposals.

Initially, Sadiq expressed his concerns in letters-to-the-editor columns in newspapers and in passionate discussions with friends. Most of them dismissed the issue as being beyond the control of ordinary citizens. But not Sadiq. As his circle of like-minded friends grew, he founded Citizens Against Weapons (CAW).

Formed about five years ago, the group’s members believe that Pakistan should be a peaceful, tolerant and weapon-free society. “The group has a few simple rules. CAW has no hierarchy, no funding from any source, no formal office or registration and complete equality and openness,” Sadiq says. “Any citizen who is committed to peace, tolerance and deweaponization is welcome to participate as an equal partner in this struggle.”

Today, 100 distinguished citizens and 13 prominent organizations—including the Human Rights Commission of Pakistan, Shehri, Citizen-Police Liaison Committee, Tehrik-e-Niswan, Pakistan Medical Association and the Pakistan Institute of Labour Education and Research—have endorsed CAW’s charter. Twenty members meet regularly to discuss strategy for creating public awareness and act as an advocacy group to lobby with the government.

CAW recently held a seminar in which civil-society members raised their concerns to draw public attention to the issues of peace and deweaponization. According to Sadiq, CAW’s agenda includes a complete ban on the issuance of all gun licences and a demand that weapons owned by private militias be eliminated under a surrender and buy-back scheme. This was proposed by the hosts and endorsed by the audience.

Lawyers involved in CAW are advocating public interest litigation. Since 2007, when former President and military ruler Pervez Musharraf dismissed the Chief Justice of Pakistan and lawyers rallied to have him reinstated, the courts have become active in redressing many wrongs that are inflicted on the people—hence this suggestion by the CAW’s lawyers.

Sadiq, who has campaigned against weapons for years, believes that gun licenses in Pakistan are “a racket.”

“Every gun license issued in the country has been issued without a single mandatory verification or test,” he claims. “There is no requirement for a training session, to attend a shooting range class or to pass a written test. The only criteria to obtain a gun license are status, power, influence and bribe.” The application form for a gun license testifies to that and gives limitless discretion to the bureaucracy, which explains why it is easy for unscrupulous men to buy a gun and hire an assassin for a few hundred thousand rupees to eliminate a rival.

Power and guns go hand in hand. People blatantly display guns to demonstrate their status. Most political parties have armed wings, and in November, an extremist religious party succeeded in holding the government hostage to its demands by blocking access to Islamabad, the capital of the country, for three weeks.

The CAW seminar drove home how guns affect Pakistan’s citizens. Dr. Seemi Jamali, executive director of one of Karachi’s major public sector hospitals, explained that an average of five or six gunshot patients are brought to her institution daily.

Those responsible for tending to the wounded are also at risk. There have been periods in the city’s history when doctors have been targeted by armed militants to create panic. From 1990 to 2004 and from 2010 to 2014, 140 health practitioners were killed in Karachi. At the seminar, the secretary-general of the Pakistan Medical Association said that these losses passed without comment by the government until the doctors went on strike. Even then, the compensation the government eventually promised the doctors’ grieving families was never given.

Although CAW demanded at the seminar that gun licenses should not be issued, it is clear that the problem is not licensing or registration alone, but the guns themselves. Pakistan is said to have 20 million guns, of which only 7 million are registered.

Many rightly feel that when a life is lost, it makes no difference whether or not the gun used was licensed. No bereaved person is comforted to know that their loved one was killed by a licensed gun.

At the CAW seminar, the father of a young man—a taxi driver named Ubaidullah Gilani, who was shot dead by unknown assailants—described his painful inability to answer his grandchild’s persistent query: “Who killed abba (father) and why?” Months had passed since Gilani’s death, and the family was still traumatized.

This explains why CAW is averse to any citizen being allowed to carry arms. It wants the government to revoke all the gun licenses previously issued and get people to surrender their firearms—even legally acquired ones. Sadiq believes that gun possession should be the exclusive domain of the state, and that no public display of firearms should be allowed.

To spread the message of deweaponization, CAW members write letters to newspapers, visit schools to talk to students, lobby with legislators and participate in any available public forum. It has held two walks to raise awareness.

At the heart of the problem is a culture that tolerates violence. In a patriarchal society, guns are a macho symbol, a concept CAW is working to change. At the recent seminar, two schoolteachers spoke about children’s fascination with firearms and toy guns and explained how they try to divert their students’ attention to the beauties of nature. Rumana Husain, a CAW member who is trying to mobilize teachers, also points out the importance of persuading toy stores to remove toy guns from their shelves and replace them with more peaceful playthings. As a children’s book author and an ambassador of the Children’s Literature Festival, Husain is working hard to popularize books in order to replace guns as a leisure pastime.

I believe it is also time to introduce peace studies in Pakistan’s schools, colleges and universities. If youths learn about conflict resolution and the destructiveness of war, their attitudes toward guns and violence will begin to change. At present, only four of the nation’s 163 universities offer post-graduate peace programs. (Two, ironically, are owned by the armed forces.)

The seminar’s final word came from Sheema Kermani, a fiery peace activist who has defied military dictatorships in Pakistan with her bold and beautiful dances and choreography. She recited “What I Will,” a poem by Suheir Hammad, a Palestinian-American poet, which should clinch the argument for peace and deweaponization:

I will not
dance to your war
drum. I will
not lend my soul nor
my bones to your war
drum. I will
not dance to your
beating. I know that beat.
It is lifeless. … I
will craft my own drum. Gather my beloved
near and our chanting
will be dancing. Our
humming will be drumming. I
will not be played. I
will not lend my name
nor my rhythm to your
beat. I will dance
and resist and dance and
persist and dance. This heartbeat is louder than
death. Your war drum ain’t
louder than this breath.

Patients in a waiting room at the Sindh Institute of Urology and Transplantation in Pakistan. (SIUT)

By Zubeida Mustafa

In a Third World country, “health for all” cannot be taken for granted, given the iniquitous provision of welfare and health care, combined with rampant poverty. So it comes as a surprise to me, a citizen of Pakistan, that health care should be the subject of such a fierce debate in the United States, where many of the problems faced by Pakistanis do not exist. This world power, after all, has the resources to provide the best health care for its people, if it wants to.

Yet Truthdig’s search engine brought up 708 results for the last few months when I keyed in the words “health care.” It was eye-opening. It is clear that, despite the heated argument surrounding the Affordable Care Act, or “Obamacare,” that marked the advent of the Trump administration and the president’s failed efforts to repeal it, the controversy has not been laid to rest.

Michael Winship’s article titled “One Nation in Sickness and in Health” very cogently sums up America’s health care problem. “It’s a given that our health care system, one-sixth of our nation’s economy, is a nightmare,” he writes. Winship attributes this “nightmare” to the “stinkers out there so quick to abuse the system and make a quick big fast buck, especially in the pharmaceutical and health insurance industries.” Winship argues that reforms are necessary to attain the ultimate goal of making “universal health care a right for every one of us.”

Ironically, we in Pakistan face somewhat similar problems to the U.S.—albeit on a humongous scale: The factors that have led to a flawed health care system in Pakistan are different. They are mainly scarce resources, an expensive private sector for a handful of elites, no feasible medical insurance and a government that lacks political will and sensitivity to upgrade the existing ramshackle health care system

Health reforms in Pakistan have met equally formidable resistance as in the U.S., where reforms in the health sector have always triggered major political battles. We in Pakistan have done slightly better at creating health care reforms from time to time, some of which were perfect on paper. But alas, these reforms were never implemented, even decades later.

So our quest for a health utopia continues. In an ocean of despondency, ill health and morbidity, we Pakistanis, however, have a few islands of excellence. One institution in particular has the greatest potential when it comes to offering health solutions in universally challenging circumstances: the Sindh Institute of Urology and Transplantation (SIUT). The SIUT, a tertiary care hospital based in Pakistan’s most populous city, Karachi, has been sustained for more than four decades, during which it has grown incrementally in size and reach. The principles that underpin the SIUT’s model of health care could be adapted, adjusted and modified by any country to suit its own circumstances.

As a starter, one needs full commitment to the precept spelled out by the World Health Organization: “Health for all.” Many Americans fight to uphold this concept as a universal right. And health care should be seen as a fundamental right of all human beings and be the ultimate goal of all states. Dr. Adibul Hasan Rizvi, founder and director of the SIUT, labels it the “birthright of every person.” This translates into his institute’s motto: “We will not allow anyone to die because he cannot afford to live.”

Rizvi adds, “We offer health care free with dignity to every one irrespective of colour, creed, caste or religious beliefs.”

Dr. Adibul Hasan Rizvi, founder and director of the SIUT. (SIUT)

And he means it. This is proved by the presence of mammoth crowds that throng the SIUT’s premises in search of succour. All treatment is free, despite the state-of-the-art technology involved, which is expensive. As might be expected, the overwhelming majority of the patients are poor, coming from the 39 percent of Pakistan’s population classified as suffering from multidimensional poverty, who have traditionally been denied adequate health care. At the SIUT, even the most costly laboratory tests or surgical procedures are provided for free, and the ailing are treated with compassion and dignity. “This approach hastens the healing process,” a bladder cancer survivor confided in me after he was pulled out of the jaws of death in this hospital. The SIUT’s Hanifa Suleman Dawood Oncology Centre offers cutting-edge technology for cancer treatment, and last year treated 34,420 patients free of charge.

In 2016, the last year for which consolidated figures are available, 1.1 million people received treatment at the SIUT. Services provided included 8.8 million laboratory tests, 367 renal transplantations and 302,037 dialysis sessions. These can be frightfully expensive, especially transplantation and post-transplant medications, which have to be taken for life. By making its services available and free of charge, the SIUT, with its high success rate, has saved hundreds of thousands of lives. By adopting this approach it has also intervened in the illegal organ trade in Pakistan. The southern province of Sindh, where the SIUT is located, has never experienced the ignominy of hosting an organ bazaar.

How has the SIUT’s miracle worked? The institute is a partnership between the government and the common man. The government facilitates the working of the institute, an autonomous body in the public sector, by partially funding it through budgetary allocations, physical infrastructure where available and project grants. The community’s role is crucial. While the affluent members of the public donate generously, the poor also drop a five-rupee coin in the collection box—such boxes are scattered all over the city. Businesspeople and industrialists have donated buildings and medical equipment worth millions. This combined effort makes it possible for the SIUT to expand—it now has 12 premises under its wings, with three outside Karachi. Donations enable the SIUT to provide free treatment to the community, which reciprocates by showing a sense of ownership toward it.

To instill this confidence in the public, the institution must be seen as delivering on its promises. Any health care system that benefits the underprivileged inspires confidence in the donors and becomes sustainable in due course of time.

People gathered outside the outpatients department of the Sindh Institute of Urology and Transplantation in Pakistan. (SIUT)

No donor wants to feel cheated, which is why wastefulness and profiteering are the biggest enemies of such a relationship. To sustain confidence, expansion at the SIUT is incremental and strictly need-based. It has grown from its initial six beds to 900 beds today. Other health care facilities have tried to emulate the SIUT, but after many adjustments, Rizvi says the viability of the SIUT model is successful because it has been sustained for 42 years, expanding even while the national economy has shrunk. In 1975 the Pakistani rupee was worth almost 10 to a dollar. Today, it is 110.

It is, however a young woman—Aymen Khan, 19—who is the best ambassador for the SIUT. Born with bladder exstrophy, a rare and dangerous bladder condition, Aymen commented, when I first interviewed her five years ago, “To God I owe my birth and to SIUT I owe my health.” Had it not been for the SIUT, Aymen would not have the normal life she leads today as a university student and sports enthusiast. Her family could never have paid her medical bills at a private health care facility.

JUST a few weeks ago there was an example of the inter-related fragility of our political-religious equilibrium. The wording of the oath for elected representatives was altered. The drift of reaction was that the reworded version insulated avowal of the finality of prophet-hood.

The previous wording was rapidly restored before cries of heresy and the like gained violent momentum. But the matter gave clerical-conglomerate cause for a rally; and the fact of the cancelled alteration is there to be referred to by those who choose to find Islamic intent deficient in the way persons or parties of their naming practice politics. Continue reading “Fragility”

Haleema Khan (a name used in this story to preserve her anonymity) is a health management expert who is head of the secretariat in a prestigious hospital in Karachi, Pakistan’s biggest city. Efficient, professional and confident, one would never guess that Khan reached the heights of success by starting from the lowest rung of the ladder.

Khan grew up in a shanty town in the backwaters of Karachi, where she was born to parents who suffered from leprosy. This concentration of humble dwellings was home to the outcasts of society, and Khan, who had never contracted the disease herself, inherited a lowly status by virtue of her parentage. The stigma attached to leprosy has haunted her all her life (and is why she was reluctant to reveal her identity for this story). Read on

FOUZIA is 13 and is employed by a working mother of two children. Fouzia is the victim of oppression on three counts. She performs the duties of an adult woman, which would be classified as child labour. She is not attending school as is compulsory for children from five to 16 years of age under Article 25-A of the Constitution.

Above all, she will soon be another example of early marriage as she is said to be engaged. The wedding will take place as soon as she has earned enough for her dowry. In the process, Fouzia has been robbed of her childhood and an education.

These deprivations do not bother this young girl’s family. Their sociocultural norms and, according to many, poverty have landed her in this ugly situation. According to Unesco, from 1987 to 2005, early marriage was the fate of nearly 32 per cent of all children in Pakistan. Continue reading “No child’s play”

A SILENT language revolution is changing the face of Pakistan in the public discourse. There was a time when proceedings in most dialogues were conducted in English. As could be expected, the message conveyed by the speakers would not get across to the entire audience.

Mercifully, things have begun to change. Bilingualism is the order of the day with greater weightage being given to indigenous languages. Those who really want to communicate with the audience — politicians and the electronic media — are aware that they would have few takers if they were to speak in English as not many understand the nuances of this foreign language and even fewer can speak it. This acknowledgment of the reality is a positive development, especially when we claim to be a democracy. Continue reading “Creeping changes”

WHEN you start to despair — and we have too many occasions for that — go get the light of hope from someone who holds the candle. So I went to see Dr Ruth Pfau, who has been an inspiration for many, especially the most stigmatised of segments — her leprosy patients.

Even in her poor state of health in her hospital bed, Dr Pfau continues to be the candle of hope she has epitomised. She was hospitalised recently but is now in her own apartment in her neat and prim clinic. Of course, she is happy to be back home, she told me.

As I held her hand I could feel the “enrichment flow from her into me” to use her words. That is the role she has been playing since she arrived as a young woman of 31 in Karachi from Germany in 1960 and made Pakistan her home. It was chance that took her to the Lepers’ Colony behind the commercial offices on McLeod Road (now I.I. Chundrigar Road). The squalor and subhuman conditions did not deter her. Within three years, she had set up a proper leprosy clinic, now an eight-storey hospital on Shahrah-i-Liaquat, and the hub of 157 leprosy centres all over the country. There followed an arduous journey of over five decades devoted to “serving the unserved”. At no stage has her commitment slackened. Continue reading “Candle of hope”

May 12th 2017 is as good as come and gone. As I recall 2007—the year of CJP Iftikhar Chaudhry, for his persona was at once the catalyst and dynamic—that May 12th anniversary marker’s mood-content would be anachronistic today. Its villains and martyrs have squirmed and shifted, and are no longer held firmly within the mould of that year’s context.

IN a society as morally perverse and corrupt as ours, does a centre of ethics have any relevance? A cynic’s answer would be a resounding ‘none whatsoever’. The idealist/reformer would say, ‘all the more’. That is a dilemma that faces all activists in this country seeking to light the spark of change.

In this context, the SIUT’s Centre for Biomedical Ethics and Culture (CBEC) faces a daunting challenge. It has been struggling for the last 13 years to introduce an ethical perspective not just in healthcare but also in the non-medical sector. Its endeavours became meaningful and received international recognition when last week WHO declared the CBEC a Collaborating Centre for Bioethics — one of the eight to receive that prestigious status worldwide. Continue reading “Right vs wrong”